Mental illness in children: Know the signs

Featuring content from Mayo Clinic

Mental illness in children can be hard for parents to identify. As a result, many children who could benefit from treatment don't get the help they need. Understand the warning signs of mental illness in children and how you can help your child cope.

Why is it hard for parents to identify mental illness in children?

It's typically up to the adults in a child's life to identify whether the child has a mental health concern. Unfortunately, many adults don't know the signs and symptoms of mental illness in children.

Even if you know the red flags, it can be difficult to distinguish signs of a problem from normal childhood behavior. You might reason that every child displays some of these signs at some point. And children often lack the vocabulary or developmental ability to explain their concerns.

Concerns about the stigma associated with mental illness, the use of certain medications, and the cost or logistical challenges of treatment might also prevent parents from seeking care for a child who has a suspected mental illness.

What mental health conditions affect children?

Children can develop all of the same mental health conditions as adults, but sometimes express them differently. For example, depressed children will often show more irritability than depressed adults, who more typically show sadness.

Children can experience a range of mental health conditions, including:

Anxiety disorders. Children who have anxiety disorders — such as obsessive compulsive disorder, post-traumatic stress disorder, social phobia and generalized anxiety disorder — experience anxiety as a persistent problem that interferes with their daily activities.

Some worry is a normal part of every child's experience, often changing from one developmental stage to the next. However, when worry or stress make it hard for a child to function normally, an anxiety disorder should be considered.

Attention-deficit/hyperactivity disorder (ADHD). This condition typically includes symptoms in three categories: difficulty paying attention, hyperactivity and impulsive behavior. Some children with ADHD have symptoms in all of these categories, while others may have symptoms in only one.

Autism spectrum disorder (ASD). Autism spectrum disorder is a serious developmental disorder that appears in early childhood — usually before age 3. Though symptoms and severity vary, ASD always affects a child's ability to communicate and interact with others.

Eating disorders. Eating disorders — such as anorexia nervosa, bulimia nervosa and binge-eating disorder — are serious, even life-threatening, conditions. Children can become so preoccupied with food and weight that they focus on little else.

Mood disorders. Mood disorders — such as depression and bipolar disorder — can cause a child to feel persistent feelings of sadness or extreme mood swings much more severe than the normal mood swings common in many people.

Schizophrenia. This chronic mental illness causes a child to lose touch with reality (psychosis). Schizophrenia most often appears in the late teens through the 20s.

Mood changes. Look for feelings of sadness or withdrawal that last at least two weeks or severe mood swings that cause problems in relationships at home or school.

Intense feelings. Be aware of feelings of overwhelming fear for no reason — sometimes with a racing heart or fast breathing — or worries or fears intense enough to interfere with daily activities.

Behavior changes. These includes drastic changes in behavior or personality, as well as dangerous or out-of-control behavior. Fighting frequently, using weapons and expressing a desire to badly hurt others also are warning signs.

Difficulty concentrating. Look for signs of trouble focusing or sitting still, both of which might lead to poor performance in school.

Unexplained weight loss. A sudden loss of appetite, frequent vomiting or use of laxatives might indicate an eating disorder.

Physical symptoms. Compared with adults, children with a mental health condition may develop headaches and stomachaches rather than sadness or anxiety.

Physical harm. Sometimes a mental health condition leads to self-injury, also called self-harm. This is the act of deliberately harming your own body, such as cutting or burning yourself. Children with a mental health condition also may develop suicidal thoughts or actually attempt suicide.

Substance abuse. Some kids use drugs or alcohol to try to cope with their feelings.

What should I do if I suspect my child has a mental health condition?

If you're concerned about your child's mental health, consult your child's doctor. Describe the behavior that concerns you. Consider talking to your child's teacher, close friends or loved ones, or other caregivers to see if they've noticed any changes in your child's behavior. Share this information with your child's doctor, too.

How do health care providers diagnose mental illness in children?

Mental health conditions in children are diagnosed and treated based on signs and symptoms and how the condition affects a child's daily life. There are no simple tests to determine if something is wrong. To make a diagnosis, your child's doctor might recommend that your child be evaluated by a specialist, such as a psychiatrist, psychologist, social worker, psychiatric nurse, mental health counselor or behavioral therapist.

Your child's doctor or mental health provider will work with your child to determine if he or she has a mental health condition based on criteria in The Diagnostic and Statistical Manual of Mental Disorders (DSM) — a guide published by the American Psychiatric Association that explains the signs and symptoms that mark mental health conditions.

Your child's doctor or mental health provider will also look for other possible causes for your child's behavior, such as a history of medical conditions or trauma. He or she might ask you questions about your child's development, how long your child has been behaving this way, teachers' or caregivers' perceptions of the problem, and any family history of mental health conditions.

Diagnosing mental illness in children can be difficult because young children often have trouble expressing their feelings, and normal development varies from child to child. Despite these challenges, a proper diagnosis is an essential part of guiding treatment.

How is mental illness in children treated?

Common treatment options for children who have mental health conditions include:

Psychotherapy. Psychotherapy, also known as talk therapy or behavior therapy, is a way to address mental health concerns by talking with a psychologist or other mental health provider. During psychotherapy, a child might learn about his or her condition, moods, feelings, thoughts and behaviors. Psychotherapy can help a child learn how to respond to challenging situations with healthy coping skills.

Some children benefit from a combination of approaches. Consult your child's doctor or mental health provider to determine what might work best for your child, including the risks or benefits of specific medications.

How can I help my child cope with mental illness?

Your child needs your support now more than ever. Before a child is diagnosed with a mental health condition, parents and children commonly experience feelings of helplessness, anger and frustration. Ask your child's mental health provider for advice on how to change the way you interact with your child, as well as how to handle difficult behavior.

Seek ways to relax and have fun with your child. Praise his or her strengths and abilities. Explore new stress management techniques, which might help you understand how to calmly respond to stressful situations.

Consider seeking family counseling or the help of support groups, too. It's important for you and your loved ones to understand your child's illness and his or her feelings, as well as what all of you can do to help your child.

To help your child succeed in school, inform your child's teachers and the school counselor that your child has a mental health condition. If necessary, work with the school staff to develop an academic plan that meets your child's needs.

If you're concerned about your child's mental health, seek advice. Don't avoid getting help for your child out of shame or fear. With appropriate support, you can find out whether your child has a mental health condition and explore treatment options to help him or her thrive.

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